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Weaning from long-term mechanical ventilation

Hospital for Special Care, New Britain, CT, USA;University of Connecticut Medical School, Farmington, CT, USA

J J Vottol

Hospital for Special Care, New Britain, CT, USA;University of Connecticut Medical School, Farmington, CT, USA;Paul J Scalise M. D. ChiefofPulmonary Medicine, Hospital for Special Care, New Britain, CT 06053, USA; pscalise{at}hfsc.org

As many as 5% of patients who need mechanical ventilation will require prolonged mechanical ventilation (PMV). The cost of their care and its associated morbidity is alarming; however, good outcomes can be achieved when their care is specialized and delivered in a programmatic manner. In this article, we review some of the common and potentially reversible reasons why patients fail successfully liberation from mechanical ventilation. We examine the outcomes of patients requiring PMV and present evidence that supports the development of specialized units where patients can be cohorted and may produce better outcomes than would be likely if these patients remained in the ICU.

Key Words: mechanical ventilation • weaning

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